Pregnancy

Introduction to diet during pregnancy

General diet for pregnancy

Eating healthily during pregnancy is important for the mum’s health and the health of the offspring. Issues to particularly watch are weight gain (ensuring it is adequate but not excessive as that can cause problems for the baby and for mum and getting adequate nutrients.

HEALTHY EATING guidelines apply to pregnancy too such as having some starchy food, preferably wholegrain, with each meal, watching the amount of salt and saturated fat in the diet. Alcohol is a poison which crosses the placenta. Excess consumption can damage the baby so women need to try and cut down as much as possible so that no more than 1 unit a day is consumed.

NUTRIENTS TO PAY PARTICULAR ATTENTION TO DURING PREGNANCY

Calcium and vitamin D

This is particularly important during the 3rd trimester when the baby’s bones are growing rapidly. At this stage the mother’s supplies may be diminished and so lead to poor teeth and osteoporosis. Good sources are milk and dairy products, these are the best absorbed, or fish bones (e.g. sardines) and foods that contain baking powder (calcium carbonate) such as scones.

Vitamin D is needed to absorb calcium and this is found in margarine, eggs and oily fish . It is also produced by the body when sunlight falls on the skin. To safeguard vitamin D intake pregnant women should take a 10 mcg supplement of vitamin D daily

Iron

This is required by both mum and the developing foetus. Sources include red meat, pulses, green leafy vegetables and fortified breakfast cereals. Iron sources which are not from meat need Vitamin C for absorption. Avoid drinking tea or coffee with a meal as the tannins in them will inhibit iron absorption.

 Folic Acid

In the first three months of pregnancy this vitamin has recently been shown to reduce the incidence of neural tube defects such as spinabifida and hydrocephalus. For this reason it is recommended as a supplement preconceptionaly and up to 12 weeks of pregnancy. (N.T.D. is a rare condition. If you are over 12 weeks pregnancy you will be asked to take the supplement if you plan another pregnancy. The dose required is 0.4mg which can be obtained from a chemist or health food shop or ask your G.P. In addition to this supplement a good dietary source of 0.2mg of folic acid is recommended. In the last trimester folic acid is required in adequate doses as it is taken up by the foetus; shortages may lead to a form of anaemia. Sources include lettuce, raw or lightly cooked green leafy vegetables, fortified breakfast cereals, bread, potatoes, yeast extract, nuts and fruit. It is a delicate vitamin and so easily destroyed. Steamed, stir-fried and microwave vegetables cooked for a short time loose less vitamins. Poor or long storage of fruit and vegetables will also cause loss of valuable vitamins including folic acid.

PROBLEMS RELATED TO DIET DURING PREGNANCY.

Nausea This is common from around 6-9 weeks up to about 16 weeks but it can occur from 2 weeks right through to the end (this is rare) As it is often worse when the tummy is empty the solution is to consume starchy snacks. A couple of semi sweet biscuits before rising may alleviate morning sickness. See overhead transparency 3:3 for suggestions of starchy snacks. Other suggestions to relieve nausea include avoiding strong smells, including perfumed. If smell of cooking affects you then get someone else to cook or eat cold food. Travelling may make the nausea worse. Small frequent meals are best.

Constipation

This happens due to the decrease in gut mobility caused by the pregnancy hormones. If on Iron supplements this can also give rise to constipation The solution is to ensure that there is adequate fibre in the diet and to drink sufficient fluid (about 8 cups a day) Gentle exercise encourages gut mobility too.

Heartburn/Indigestion

This may occur as the baby gets larger and pushes against the tummy. It can also occur due to decreased muscle tone and can start from about 3 months onwards. Solutions are to eat little and often. Eating yoghurt and milk may help. Relax and sit up during meal times. Avoid lying down for an hour or so after eating and so don’t eat a big meal too soon before going to bed. Spicy foods may cause heartburn as may fatty foods, citrus fruits and fizzy drinks.

FOOD HYGIENE

A pregnant mum is more susceptible to food poisoning and some of the food born organisms can be dangerous and even life threatening to the unborn child. So it is worth taking extra care.

General points:

1 Eat food within its “consume by” date

2 Follow correct microwave procedures to avoid uncooked cold spots such as stirring food half way through cooking and allowing standing times.

3 Buy a fridge thermometer and make sure the temperature remains between 1-4 degrees C

4 Allow foods to cool quickly and then cover and store in the fridge. Do not re-heat cooked food more than once

5 Cooked and raw food should be stored separately.

6 Cook all meat thoroughly, not just pork and chicken

7 Wash all fruit and vegetables thoroughly before eating.

Listeria may cause miscarriage and still births. To avoid do not consume soft cheeses and blue veined cheeses. Eat no meat and fish pates and pastes except for the tinned sort.

Salmonella  will make the individual feel very unwell with violent sickness and diarrhoea. It can be carried in the blood and cause infection in others for months afterwards. To avoid do not consume raw or runny eggs. Do not consume dishes containing raw eggs.

 Toxoplasmosis can affect the unborn child and symptoms may vary from hydrocephalus to retina damage and it may also cause miscarriage. It is carried by the cat and can be spread via its faeces. Therefore always wash hands after handling a cat and avoid having to empty its litter tray. Always wear gloves while gardening and wash hands thoroughly afterwards. As with general food hygiene it is important to wash all fruit and vegetables and as the organism can live in all meats it is important to cook all meat thoroughly. Avoid unpasteurized milk and its products, this includes goats and sheeps milk.

Special Warning about Liver and liver prodcts

Animals store a very high amount of Vitamin A in their liver so that as it is a fat soluble vitamin and not easily excreted a pregnant women consuming this amount of vitamin a may cause a high toxic level to be passed to the foetus. In turn this may cause birth defects This is very rare and it is only habitual consumption which has caused the problems. However it is best avoided altogether along with liver products such as pates and liver sausage, Rich Vitamin A sources are best avoided too such as Cod liver oil. However the quantity of Vitamin A in an ordinary multivitamin is safe.

WEIGHT GAIN

There is no need to eat for two but on the other hand restricting weight gain may result in a weak low birth weight baby. Let your appetite be a guide. During pregnancy the metabolism slows down and mum is generally less active . The body becomes more efficient at absorbing vitamins too. So on average only about an extra 200 kCals is needed in the last trimester of pregnancy.

The average weight gain is 10-12 kg (11/2-2 stone) 8lbs is gained during the first 20 weeks and then an average of 1 lb a week If you are overweight at the start of pregnancy then weight still needs to be gained but only about 1 stone. If you are under weight at the start of pregnancy then more than the average amount of weight needs to be gained to ensure baby is a good weight at birth i.e. about 2.5 stone

Excess weight gain could give rise to gestational diabetes and the problems associated with that, such as a large baby which is difficult to deliver. It could also cause a rise in blood pressure and also cause long term obesity. A little excess weight gain may be lost by breast feeding. It is best to concentrate on eating nutrient dense foods and not those that provide “empty calories” Recent research has also shown that if a mother gains excess weight during pregnancy she can pass on a tendency to diabetes and obesity to her offspring

Thursday, October 19th, 2017

Pregnancy and Dental Care

There is now a  guide (https://www.emergencydentistsusa.com/dental-care-pregnancy/) which  covers oral health before, during and after pregnancy. It outlines all the reasons to take it seriously as well as highlighting all the key considerations for those conceiving or expecting.

The resource aims to answer all your main questions surrounding pregnancy and dental care so that you know what dental precautions are necessary at various stages and when it is necessary to see your dentist in order to prevent a major health issue developing during the time between conception and birth.

 

You're Questions Answered, Pregnancy & Dental Care (2)

Saturday, May 25th, 2013

Even mild #iodine deficiency has noticeable cognitive affects on offspring

A study of 1040 mothers and their offspring published in the Lancet showed that even a mild dietary deficiency of iodine affected the child’s cognitive development.

Iodine is known to be essential for a healthy foetal brain and neurological development. The World Health Organization (WHO) refers to its deficiency as “the single most important preventable cause of brain damage worldwide.” The UK study showed that even mild iodine deficiency in utero was linked to lower IQ and sub optimal reading ability in the offspring.

The children’s scores on the cognitive tests at age 8 to 9 years worsened when deficient group of iodine in the first trimester was lowest. WHO guidelines state that pregnant and breast-feeding women are recommended to have an intake of 250 µg of iodine per day, compared with the recommendation of 150 µg for adults who are not pregnant. It is likely that the most important time to have good iodine intake is the first trimester.

The iodine content of seafood may explain why it has been shown to be great in boosting verbal IQ scores of offspring. As well as seafood, other dietary sources of iodine include dairy products, especially cow’s milk.  However,  organic milk has an iodine content that is 40% lower than conventional milk. Iodized salt is also a good source in some countries but salt is not iodized in the UK. Women should not go overboard with supplements if they feel they are not getting enough iodine; a multivitamin and mineral supplement is fine but high dose supplements such as what are found in kelp and seaweed may provide too much which can be just as harmful

Experts suggested that the study showed that there was a need for a call to action to public-health policy makers in the UK;  Absence of a public-health policy in the face of clear documentation of moderate iodine deficiency and strong evidence of its deleterious effect on the neurodevelopment of children . They also suggested that unmonitored and adventitious dietary iodine sources continue to be relied on.

 

Lancet . Published online May 22, 2013. Abstract Editorial

Tags: , ,

Sunday, March 17th, 2013

Fish oil (DHA) during pregnancy can reduce incidence of very pre-term births

In pregnancy, eating two helpings of oily fish a week, or taking a fish oil supplement of omega-3 fatty acid docosahexaenoic acid (DHA), may help reduce the likelihood of giving birth very prematurely.

New research showed that taking DHA reduced the riskiest preterm births: Researchers took 350 women between eight and 20 weeks pregnant and gave them either a supply of capsules, each containing 200 mg of algae-derived DHA, to take three times a day until giving birth, or placebo. It was found that women taking the DHA supplements tended to have slightly larger, heavier babies and to give birth about three days later than the placebo group. Also the placebo group had considerably more births of very early premature births: Five percent of mothers in the placebo group had their babies at less than 34 weeks, compared to less than 1% in the omega-3 group.

DHA, an essential fatty acid, can’t be manufactured in the body and must be obtained by eating oily fish or taking it as a supplement .It seems that at least 600 mg is necessary for the beneficial effect. Eating oily fish during pregnancy is therefore beneficial, up to twice a week. Pregnant women should just avoid fish high in mercury, like swordfish, tilefish, mackerel and shark.

SOURCE: http://bit.ly/XkQxmJ Am J Clin Nutr 2013.

Tags: , ,

Categories